Provider Demographics
NPI:1861690372
Name:WHITE, CASSIE RUSH (LPN)
Entity type:Individual
Prefix:MRS
First Name:CASSIE
Middle Name:RUSH
Last Name:WHITE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 HERALD ST
Mailing Address - Street 2:ROCHESTER
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14621-4907
Mailing Address - Country:US
Mailing Address - Phone:585-313-5175
Mailing Address - Fax:
Practice Address - Street 1:161 HERALD ST
Practice Address - Street 2:ROCHESTER
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-4907
Practice Address - Country:US
Practice Address - Phone:585-313-5175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-05
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY267425164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse